Long-term weight loss maintenance in the United States

Abstract

Context Although the rise in overweight and obesity in the United States is well documented, long-term weight loss maintenance (LTWLM) has been minimally explored. Objective The aim of this study is to estimate the prevalence and correlates of LTWLM among US adults. Design, setting and participants We examined weight data from 14 306 participants (age 20–84 years) in the 1999–2006 National Health and Nutrition Examination Survey (NHANES). We defined LTWLM as weight loss maintained for at least 1 year. We excluded individuals who were not overweight or obese at their maximum weight. Results Among US adults who had ever been overweight or obese, 36.6, 17.3, 8.5 and 4.4% reported LTWLM of at least 5, 10, 15 and 20%, respectively. Among the 17.3% of individuals who reported an LTWLM of at least 10%, the average and median weight loss maintained was 19.1 kg (42.1 pounds) and 15.5 kg (34.1 pounds), respectively. LTWLM of at least 10% was higher among adults of ages 75–84 years (vs ages 20–34, adjusted odds ratio (OR): 1.5; 95% confidence interval (CI): 1.2, 1.8), among those who were non-Hispanic white (vs Hispanic, adjusted OR: 1.6; 95% CI: 1.3, 2.0) and among those who were female (vs male, adjusted OR: 1.2; 95% CI: 1.1, 1.3). Conclusions More than one out of every six US adults who has ever been overweight or obese has accomplished LTWLM of at least 10%. This rate is significantly higher than those reported in clinical trials and many other observational studies, suggesting that US adults may be more successful at sustaining weight loss than previously thought.

MECHANISMS IN ENDOCRINOLOGY: Hypothalamic inflammation and nutrition

“…Most obese humans seeking medical and nutritional attention to control adiposity fail to maintain body mass reduction for prolonged periods (39,40,41). Even patients submitted to bariatric surgery present some body mass regain years after surgery (42).…”

Descriptive Study of Educated African American Women Successful at Weight-Loss Maintenance Through Lifestyle Changes

“…[3][4][5][6] The 1999-2006 National Health and Nutrition Examination Survey estimates 15 % of African American adults who have ever been overweight have experienced long-term (≥ 1 year) weight loss maintenance of at least 10 %, versus 19 % of nonHispanic whites. 7 In clinical practice, a 10 % weight loss improves blood pressures, blood sugars, and lipids and is the clinically recommended goal for individuals trying to reduce weight. [7][8][9] At present, there is scant evidence on highly successful weight-loss programs among African Americans.…”

“…7 In clinical practice, a 10 % weight loss improves blood pressures, blood sugars, and lipids and is the clinically recommended goal for individuals trying to reduce weight. [7][8][9] At present, there is scant evidence on highly successful weight-loss programs among African Americans. The National Weight Control Registry (NWCR) identified a large sample of individuals who were successful at longterm weight loss maintenance.…”

“…These methods have been used in other studies and are imperfect but of acceptable reliability. 7,10,18,19 To further support accuracy of reported weight change by individuals identified as weight loss maintainers, participants were asked to identify a significant referent (e.g. physician, friend) who could verify their reported weight loss.…”

“People don't care as much about their health as they do about their looks”: Personal trainers as intermediaries between aesthetic and health-based discourses of exercise participation and weight management

“…The simple prescriptions to "eat less and move more" are becoming complicated by research findings that show how a 5 wide range of metabolic processes are affected by weight loss and implicated in the weight regain that often follows (e.g., Rosenbaum, Hirsch, Gallagher, & Leibel, 2008;Sumithran et al, 2011). Despite the increasing sophistication of exercise and nutrition programs designed for weight loss, sustained weight loss remains an elusive goals for many people; although the precise success rate for long term maintenance of weight loss is difficult to determine, a recent review suggests that only around 17% of Americans who have ever been overweight or obese have maintained a loss of at least 10% of their body weight for at least one year (Kraschnewski et al, 2010). In addition to the considerable problems with establishing the efficacy of weight loss programs, there is the potential for iatrogenic effects of deliberate weight loss attempts.…”